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General NPI Number Information
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NPI Number | 1235385675
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Entity Type | Individual
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Provider Name | KAREN ANN BOCKLI MD
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Gender | Female
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 5841 S MARYLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60657
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Country | US
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Telephone | 734-717-9346
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Fax |
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Provider Business Mailing Address
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Address Line | 2305 W ROSCOE APT 1E
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City | CHICAGO
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State | IL
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Zip | 60618
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 036123892
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License Number State | IL
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